RESEARCH PAPER
Associations between Appalachian youth tobacco consumption and communication channel use
Jack Pfeiffer 1
,  
Jayesh Rai 3, 4
,  
Clara G. Sears 1, 2
,  
Kandi L. Walker 1, 2, 5
,  
Joy L. Hart 1, 2, 5  
 
 
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1
Department of Communication, University of Louisville, Louisville, United States
2
American Heart Association Tobacco Regulation and Addiction Center, Dallas, United States
3
Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, United States
4
School of Medicine, Diabetes and Obesity Center, University of Louisville, Louisville, United States
5
School of Medicine, Envirome Institute, University of Louisville, Louisville, United States
CORRESPONDING AUTHOR
Joy L. Hart   

Department of Communication, University of Louisville, Louisville, Kentucky, United States
Publication date: 2020-03-24
Submission date: 2019-11-04
Final revision date: 2020-02-02
Acceptance date: 2020-02-17
 
Tob. Prev. Cessation 2020;6(March):21
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Youth tobacco use rates in Appalachia exceed the US national average, and e-cigarette use has increased. Thus, further research is needed to understand how these youth receive and share product information.

Methods:
Middle and high school students in rural Appalachia were surveyed (N=1103). The primary outcome, tobacco use, was categorized as: never users, cigarette-only users, smokeless-only users, e-cigarette-only users, and polytobacco users. Associations between receiving or sharing conventional tobacco-related or e-cigarette-related information via specific communication channels and tobacco use were assessed.

Results:
Participants who received tobacco information from friends and family (FF) (OR=1.87; 95% CI: 1.35–2.57), public displays (PUB) (OR=1.49; 95% CI: 1.09–2.05), and digital media (DIG) (OR=1.95; 95% CI: 1.41–2.70) and e-cigarette information via the same communication channels, FF (OR=2.65; 95% CI: 1.93–3.65), PUB (OR=1.62; 95% CI: 1.17–2.26), and DIG (OR=2.24; 95% CI: 1.61–3.12), had greater odds of being polytobacco users, compared to never users. Participants who received e-cigarette-related information from FF (OR=2.42; 95% CI: 1.42–4.13) and PUB (OR=2.13; 95% CI: 1.25–3.65) had greater odds of being e-cigarette-only users compared to never users. Participants who shared e-cigarette-related information with FF had greater odds of being e-cigarette-only users (OR=3.16; 95% CI: 1.80–5.58) and polytobacco users (OR=4.48; 95% CI: 3.16–6.35) compared to never users.

Conclusions:
Receiving and sharing tobacco-related and e-cigarette-related information via multiple communication channels is associated with e-cigarette and polytobacco use among Appalachian youth. Several channels may need to be utilized in health campaigns to influence youth.

ACKNOWLEDGEMENTS
We thank Shesh Rai for his assistance with data analysis; Alexander Lee, Allison Sia, and Courteney Smith for help with data collection; and the University of Louisville research computing group and the Cardinal Research Cluster, whose resources facilitated facets of this work.
CONFLICTS OF INTEREST
The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. All authors report that they received grants from the National Institutes of Health and the Food and Drug Administration during the conduct of the study.
FUNDING
Research reported in this publication was supported, in part, by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) and the Food & Drug Administration’s Center for Tobacco Products (CTP) under Award Numbers P50HL120163 and U54HL120163. The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, the Food & Drug Administration, or the American Heart Association.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
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